@article {Kallet1008, author = {Richard H Kallet and James A Alonso and Jean-Fran{\c c}ois Pittet and Michael A Matthay}, title = {Prognostic Value of the Pulmonary Dead-Space Fraction During the First 6 Days of Acute Respiratory Distress Syndrome}, volume = {49}, number = {9}, pages = {1008--1014}, year = {2004}, publisher = {Respiratory Care}, abstract = {BACKGROUND: The ratio of pulmonary dead space to tidal volume (VD/VT) in acute respiratory distress syndrome (ARDS) is reported to be between 0.35 and 0.55. However, VD/VT has seldom been measured with consideration to the evolving pathophysiology of ARDS. METHODS: We made serial VD/VT measurements with 59 patients who required mechanical ventilation for >= 6 days. We measured VD/VT within 24 h of the point at which the patient met the American-European Consensus Conference criteria for ARDS, and we repeated the VD/VT measurement on ARDS days 2, 3, and 6 with a bedside metabolic monitor during volume-regulated ventilation. We analyzed the changes in VD/VT over the 6-day period to determine whether VD/VT has a significant association with mortality. RESULTS: VD/VT was significantly higher in nonsurvivors on day 1 (0.61 {\textpm} 0.09 vs 0.54 {\textpm} 0.08, p \< 0.05), day 2 (0.63 {\textpm} 0.09 vs 0.53 {\textpm} 0.09, p \< 0.001), day 3 (0.64 {\textpm} 0.09 vs 0.53 {\textpm} 0.09, p \< 0.001), and day 6 (0.66 {\textpm} 0.09 vs 0.51 {\textpm} 0.08, p \< 0.001). CONCLUSION: In ARDS a sustained VD/VT elevation is characteristic of nonsurvivors, so dead-space measurements made beyond the first 24 hours may have prognostic value.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/49/9/1008}, eprint = {https://rc.rcjournal.com/content/49/9/1008.full.pdf}, journal = {Respiratory Care} }